title: Experiences with tumour necrosis factor-{alpha} inhibitors in patients with juvenile idiopathic arthritis: Hungarian data from the National Institute of Rheumatology and Physiotherapy Registry.
abstract: OBJECTIVE
  To report the efficacy and safety of TNF-α inhibitors (etanercept and adalimumab) in a cohort of patients with JIA treated in a single paediatric rheumatological centre.
  
  
  METHODS
  Patients with JIA under the age of 18 years, treated with TNF-α blockers at the Paediatric Rheumatologic Centre of the National Institute of Rheumatology and Physiotherapy (Budapest, Hungary) from 2002, were enrolled in an open, observational study. At baseline, patient and disease characteristics were registered. Disease activity was evaluated (before the start of the treatment and after every 3 months) according to the JIA core set of the ACR paediatric definition of improvement (ACR Pedi). Adverse events (AEs) were documented.
  
  
  RESULTS
  In all, 72 patients were evaluated. Mean (S.D.) age at onset was 5.5 (3.8) years, mean disease duration was 7.4 (3.9) years. All disease activity parameters improved significantly in the first 3 months of treatment. After 3 and 12 months of treatment, 88 and 76% of patients, respectively, achieved the criteria of the ACR Pedi 30. AEs were uncommon. After 12 months, >85% of patients continued the therapy.
  
  
  CONCLUSIONS
  Anti-TNF-α agents (etanercept and adalimumab) are effective, safe and well tolerated in JIA patients. Extension of this study for a longer follow-up period and to the patients with JIA after the age of 18 years (with validated and comparable disease activity parameters) is needed to evaluate the long-term effectiveness and safety of the TNF-α inhibitors.
authors.affiliation: Department of Clinical Immunology, Adult and Paediatric Rheumatology, National Institute of Rheumatology and Physiotherapy, Frankel Leo Str. 38-40, Budapest 1023, Hungary. sevcic.krisztina@freemail.hu.
authors.forename: Krisztina
authors.initials: K
authors.lastname: Sevcic
authors.forename: Ilonka
authors.initials: I
authors.lastname: Orban
authors.forename: Valentin
authors.initials: V
authors.lastname: Brodszky
authors.forename: Anna
authors.initials: A
authors.lastname: Bazso
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Balogh
authors.forename: Gyula
authors.initials: G
authors.lastname: Poor
authors.forename: Emese
authors.initials: E
authors.lastname: Kiss
mesh_terms: D000068879:Adalimumab; D000293:Adolescent; D000704:Analysis of Variance; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001171:Arthritis, Juvenile / Q000175:diagnosis / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D000068800:Etanercept; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006814:Hungary; D007074:Immunoglobulin G / Q000627:therapeutic use*; D008297:Male; D010147:Pain Measurement; D016059:Range of Motion, Articular / Q000502:physiology; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use*; D012042:Registries; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000068879:Adalimumab; D000068800:Etanercept